Clinical effectiveness of oral antiviral agents for treating non-hospitalized COVID-19 patients with chronic kidney disease.

Chen, Chia-Chen; Huang, Chi-Ya; Wu, Jheng-Yan; Liu, Mei-Yuan; Chuang, Min-Hsiang; Liu, Ting-Hui; Tsai, Ya-Wen; Hsu, Wan-Hsuan; Huang, Po-Yu; Chen, Ming-Hui; Liu, Su-Yen; Lee, Mei-Chuan; Hung, Kuo-Chuan; Lai, Chih-Cheng; Yang, I-Ning

Chen, Chia-Chen; Huang, Chi-Ya; Wu, Jheng-Yan; Liu, Mei-Yuan; Chuang, Min-Hsiang; Liu, Ting-Hui; Tsai, Ya-Wen; Hsu, Wan-Hsuan; Huang, Po-Yu; Chen, Ming-Hui; Liu, Su-Yen; Lee, Mei-Chuan; Hung, Kuo-Chuan; Lai, Chih-Cheng; Yang, I-Ning.

Afiliação

Chen CC; Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
Huang CY; Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Wu JY; Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan.
Liu MY; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Chuang MH; Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan.
Liu TH; Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan.
Tsai YW; Department of Food Nutrition, Chung Hwa University of Medical Technology, Tainan, Taiwan.
Hsu WH; Department of Health and Nutrition, Chia Nan University of Pharmacy & Science, Tainan, Taiwan.
Huang PY; Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Chen MH; Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan.
Liu SY; Center of Integrative Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Lee MC; Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Hung KC; Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Lai CC; Nursing Department, Chi Mei Medical Center, Tainan, Taiwan.
Yang IN; Nursing Department, Chi Mei Medical Center, Tainan, Taiwan.

Expert Rev Anti Infect Ther ; : 1-8, 2024 Mar 26.

Article em En | MEDLINE | ID: mdl-38525673

ABSTRACT

ABSTRACT

OBJECTIVES:

This study examined the effectiveness of nirmatrelvir plus ritonavir (NMV-r) and molnupiravir (MOV) in treating COVID-19 among chronic kidney disease (CKD) patients.

METHODS:

This retrospective cohort study, using the TriNetX research network, identified stage 3-5 CKD and end-stage kidney disease (ESKD) patients with non-hospitalized COVID-19 between 1 January 2022, and 31 May 2023. Propensity score matching (PSM) was used to compare patients on NMV-r or MOV (antiviral group) against those not receiving these treatments (control group). The primary composite outcome was the cumulative hazard ratio (HR) for all-cause hospitalization or death within the 30-day follow-up.

RESULTS:

After PSM, two balanced cohorts of 6,275 patients each were established. The antiviral group exhibited a lower incidence of all-cause hospitalization or mortality (5.93% vs. 9.53%; HR 0.626; 95% CI 0.550-0.713) than controls. Additionally, antiviral recipients were associated with a lower risk of all-cause hospitalization (HR 0.679; 95% CI 0.594-0.777) and mortality (HR 0.338; 95% CI 0.227-0.504). The beneficial effects of antiviral agents were consistent across sex, age, vaccination status, antiviral type, and CKD stage.